The influence of antibiotics and other factors on reconsultation for acute lower respiratory tract illness in primary care.
BACKGROUND
Antibiotics are prescribed to the majority of patients consulting their general practitioner (GP) for lower respiratory tract illness (LRTi). A common reason for prescription is the belief that antibiotics reduce re-attendance; a motive supported by the high reconsultation rates for this largely self-limiting illness. Information about reconsultation following treatment of LRTi, and the factors that influence it, is scarce.


OBJECTIVE
To explore factors associated with reconsultation after initial management of LRTi.


METHODS
Analysis of data collected prospectively during presentation of acute LRTi in primary care.


RESULTS
Seventy-six per cent of 518 patients were prescribed antibiotics, and 30% reconsulted for similar symptoms within the next 28 days (29% of those who were given antibiotics and 33% of those who were not). Forty-one per cent of patients who had seen their GP 15 or more times in the previous two years reconsulted, compared with 13% of those who had made fewer than five visits. Reconsultation was more common in patients with a history of underlying disease (38.6% versus 24.3%) and in patients who reported dyspnoea (41.5% versus 24.3%).


CONCLUSIONS
Reconsultation is common in acute LRTi and is associated with a heightened consulting habit prior to the index consultation, the presence of previous ill health, and dyspnoea. It appears not to be influenced by prescribing antibiotics.
Holmes
W F
WF
University of Nottingham.
Macfarlane
J T
JT
Macfarlane
R M
RM
Lewis
S
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004739:England; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents